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Factors that predict poor clinical course among patients hospitalized with pelvic inflammatory disease
Author(s) -
Terao Miyoko,
Koga Kaori,
Fujimoto Akihisa,
WadaHiraike Osamu,
Osuga Yutaka,
Yano Tetsu,
Kozuma Shiro
Publication year - 2014
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12189
Subject(s) - medicine , pelvic inflammatory disease , univariate analysis , receiver operating characteristic , surgery , multivariate analysis
Aim The aim of this study was to identify factors that can predict clinical course among patients hospitalized with pelvic inflammatory disease ( PID ). Methods Ninety‐three patients who needed hospitalization with a diagnosis of PID were retrospectively studied. Patients who were discharged within 7 days by conservative treatment were defined as favorable course cases ( n = 44). Patients who needed more than 7 days of hospitalization and/or surgery were defined as poor course cases ( n = 49). Twenty variables were evaluated by univariate and logistic regression analysis: age, history of pregnancy/delivery, gynecological open/laparoscopic surgery, PID , oral contraceptives/intrauterine device use and intrauterine operation before onset, body temperature, signs of peritoneal irritation, vomiting/diarrhea, abnormal vaginal discharge, endometriosis/fibroid/adenomyosis/any cystic lesion detected by ultrasonography, white blood cell counts/C‐reactive protein ( CRP ) levels . The cut‐off value was calculated by receiver–operator curve ( ROC ) analysis. Results Factors associated with poor clinical course were advanced age ( P < 0.01), history of gynecological open surgery ( P < 0.05), any cystic lesion detected by ultrasonography ( P < 0.05) and high CRP levels ( P < 0.05). High CRP levels and intrauterine operation before onset were independently associated with poor clinical course. The cut‐off value for CRP was 4.4 mg/dL. Conclusion This study identified variables that can predict poor clinical course of PID . These results can assist gynecologists with identifying patients at risk and optimizing the choice of management.